Key result
Postoperative cardiovascular complications after major abdominal surgery were associated with significantly higher 30-day mortality (28.5% vs. 7.1%; HR 4.15; 95% CI 3.14-5.48).
Why the study?
Postoperative cardiovascular complications increase morbidity and mortality, but ambiguity in their definition creates confusion in patient assessment and management.
Do postoperative cardiovascular complications increase 30-day mortality in patients undergoing major abdominal surgery?
Cohort (n=403)
Yes
Do postoperative cardiovascular complications increase 30-day mortality in patients undergoing major abdominal surgery?
Postoperative cardiovascular complications after major abdominal surgery are associated with a more than 4-fold increased risk of 30-day mortality.
CVCs were associated with >4-fold higher adjusted 30-day mortality after major abdominal surgery; leaves open whether prevention reduces deaths in trials.
Postoperative cardiovascular complications (CVC) are associated with higher morbidity and mortality. Ambiguity in definition of CVC creates confusion in assessment and management of patients. Objective. To determine the incidence and timing of CVC after major abdominal surgery, as well as their impact on 30-day mortality. Material and methods. A prospective cohort study was conducted between January and May 2022. Data were collected in patients who underwent major abdominal surgery. The primary outcome measure was CVC defined by the consensus “Standardized Endpoints for Perioperative Healthcare Outcomes—Key Outcomes for Perioperative and Anesthesia Care” within 30 days after surgery. The secondary outcome measure was 30-day postoperative mortality. Results. The study included 403 patients, and 21 (5.2%) ones developed CVCs. Thirty-three (8.2%) patients died within 30 days after surgery, and cardiovascular death was observed in 6 (18.2%) cases. Mortality was higher in patients with postoperative CVC (28.5% vs. 7.1%). This relationship remained after risk adjustment with hazard ratio 4.15 (95% CI 3.14—5.48). We estimated absolute mortality risk reduction by 0.4 (95% CI 0.3—0.5) in the absence of all CVCs. This would provide a relative mortality risk reduction by 21.3% if all CVCs were prevented. Conclusion. Under certain conditions, 1 out of 5 postoperative deaths related to CVC could be avoided. Our results provide a basis for further research.
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Бутырский et al. (2025) conducted a cohort in Major abdominal surgery (n=403). Postoperative cardiovascular complications vs. No postoperative cardiovascular complications was evaluated on 30-day postoperative mortality (HR 4.15, 95% CI 3.14-5.48). Postoperative cardiovascular complications after major abdominal surgery were associated with significantly higher 30-day mortality (28.5% vs. 7.1%; HR 4.15; 95% CI 3.14-5.48).
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